| NPI | 1932685740 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: OR D11766) |
| Additional Taxonomies | 122300000X Dentist (Licence: CO 00203363) |
| 208600000X Surgery (Licence: CA A182566) | |
| Enumeration Date | 2018-07-15 |
| Last Update Date | 2023-06-14 |